Obesity in pregnancy: maternal and perinatal outcome
Keywords:Maternal outcome, Obesity, Perinatal Outcome
Background: Obesity, the silent epidemic worldwide has reached a stage where approximately 2.3 billion adults will be overweight and more than 700 million adults will be obese by 2015, as projected by WHO. The objective of this study was to find out the incidence of the pregnancy complications due to maternal obesity and to assess the neonatal outcome.
Methods: Retrospective study conducted in Cheluvamba Hospital, Mysore from September 2014 to September 2015. Subjects were categorized into 3 classes based on the BMI. Class 1:30-34.9 kg/m2, class 11:35-39.9 kg/m2, Class 111: >40 kg/m2. The maternal and perinatal outcome of the subjects evaluated in relation to body mass index.
Results: A total of 56 women were included in the study, with 37 belonging to class I, 13 women class II, 6 women class III. Class III women were significantly more likely to have pre-eclampsia (83.3%, 69.2%, 27%) and post term pregnancy (50%, 38%, 16.2%) than class II and class I. The incidence of GDM (7.6%, 5.4%) and IUGR (7.6%, 2.7%) are more in class II compared to class I. Instrumental deliveries (10%, 28.5%) and LSCS (45.9%, 46.1%, 66.6%) rates increased as the BMI increased from class I to class III. Postpartum complications like PPH (5.4%, 7.6%, 33.3%) and wound gapping (7.6%, 16.6%) were on rise with increased BMI. Class III women were more likely to have macrosomic babies than class II and class III (33.3%, 15.3%, 18.9%).
Conclusions: As the BMI increases pregnancy is more likely to get complicated. Interventions directed towards weight loss and prevention of excessive weight gain must begin in the pre-conception period. Obstetrical care providers must counsel their obese patients regarding the risks and complications conferred by obesity and the importance of weight loss.
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